Effective

All lines of enquiry related to this area of the CQC inspection are listed below. Visit the CQC website if you need to clarify which ones relate to your service.

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Click on one of the icons related to the Care Quality Commission inspection questions: is it safe, effective, caring, responsive or well-led. This will show the key lines of enquiry (KLOEs) associated with each question.

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E1.1 Are people’s physical, mental health and social needs holistically assessed, and is their care, treatment and support delivered in line with legislation, standards and evidence-based guidance, including NICE and other expert professional bodies, to achieve effective outcomes?

E1.2 What processes are in place to ensure there is no discrimination, including in relation to protected characteristics under the Equality Act, when making care and support decisions?

E1.3 How is technology and equipment used to enhance the delivery of effective care and support, and to promote people’s independence?

Products that can help include...

A Better Life for older people with high support needs: the role of social care (2014) A Better Life for older people with high support needs: the role of social care (2014)

Resources to support practitioners in addressing challenges in their practice and relationships with older people with high support needs to help achieve more choice, control and quality in their lives.​​

Effective supervision which gives time for reflection and instruction is a key part of ensuring staff can deliver great care. The effective supervision guide (£20 or £15 to registered manager members) provides:

It is important that you effectively train and assess your staff; including assessing competence in the work place. Whether you're accessing new staff against the Care Certificate or existing staff, the workplace accessment guide (£20 or £15 to registered manager members) is packed with insights from award winning employers and learning providers.

You can read good practice examples, learning materials and case studies about what has been successful for other organisations using our free online best practice resource, Learn from Others. Topics covered include:

Relates to: Services that provide, prepare or serve food as part of providing regulated activity, or that support people to do so for themselves. Prompts that may be used by CQC inspectors to explore this…

E3.1 How are people involved in decisions about what they eat and drink and how are their cultural and religious preferences met?

E3.2 How are people supported to have a balanced diet that promotes healthy eating and the correct nutrition?

E3.3 Are meals appropriately spaced and flexible to meet people’s needs, and do people enjoy mealtimes and not feel rushed?

E3.4 How are risks to people with complex needs identified and managed in relation to their eating and drinking?

Nutrition support in adults (2012) (QS24) Nutrition support in adults (2012) (QS24)

NICE quality standard on nutrition support for adults in hospital and the community who are at risk of malnutrition or who have become malnourished, and adults who are receiving oral nutrition support, enteral or parenteral nutrition. It includes statements and measures on

screening for the risk of malnutrition

management care plans

documentation and communication of screening results and nutrition support goals

self-management of artificial nutrition support.

The statements are specific and concise and focus on priorities for quality improvement. In particular, please see statements 2, 3, 4 & 5.

E4.1 How do staff work together to ensure that people receive consistent, timely, coordinated, person-centred care and support when they are referred to, use, leave, or move between, different services?

Moving between hospital and home, including care homes: A quick guide for registered managers of care homes and home care (2017) Moving between hospital and home, including care homes: A quick guide for registered managers of care homes and home care (2017)

This is a short and visually appealing guide for registered managers of care homes and home care, containing key information from the relevant NICE guidance.

Transition between inpatient hospital settings and community or care home settings for adults with social care needs (2016) (QS136) Transition between inpatient hospital settings and community or care home settings for adults with social care needs (2016) (QS136)

NICE quality standard on admissions into, and discharge from, inpatient hospital settings for adults with social care needs. It includes statements and measures on;

information sharing on admission to hospital

coordinated discharge

discharge plans

involving family and carers in discharge planning.

The statements are specific and concise and focus on priorities for quality improvement. In particular, please see statement 1.

Transition between inpatient mental health settings and community or care home settings (2017) (QS159) Transition between inpatient mental health settings and community or care home settings (2017) (QS159)

NICE quality standard on transitions for children, young people and adults between mental health hospitals and their own homes, care homes or other community settings. It includes statements and measures on;

Communication and joint working across adults' and children's services

Transition between inpatient mental health settings and community or care home settings (2016) (NG53) Transition between inpatient mental health settings and community or care home settings (2016) (NG53)

NICE guideline covering the period before, during and after a person is admitted to, and discharged from, a mental health hospital. It aims to improve the way transition to and from a mental health hospital is planned and carried out.

NICE quality standard on transition from children’s to adults’ services for young people (aged up to 25). It covers the period before, during and after a young person moves from children's to adults' services and covers all health and social care services. It includes statements and measures on; • transition planning and annual review • having a named worker• introductions to adults’ services• dealing with missed first appointments after transfer to adults’ services.

The statements are specific and concise and focus on priorities for quality improvement.In particular, please see statement 1.

NG93 Learning disabilities and behaviour that challenges: service design and delivery (2018) NG93 Learning disabilities and behaviour that challenges: service design and delivery (2018)

This guideline covers services for children, young people and adults with a learning disability (or autism and a learning disability) and behaviour that challenges. It aims to promote a lifelong approach to supporting people and their families and carers, focusing on prevention and early intervention and minimising inpatient admissions.

This guideline covers recognising, assessing and treating mental health problems in women who are planning to have a baby, are pregnant, or have had a baby or been pregnant in the past year. In particular see recommendations 1.3.5 and 1.4.8

Older people with social care needs and multiple long-term conditions (2015) (NG22) Older people with social care needs and multiple long-term conditions (2015) (NG22)

​The guideline covers planning and delivering social care and support for older people who have multiple long-term conditions. It promotes an integrated and person-centred approach to delivering effective health and social care services​.

Common Core Principles for Self-Care Common Core Principles for Self-Care

Self-care is about everyone taking responsibility for their own health and wellbeing. This includes keeping both the body and mind fit and healthy. With Skills for Health we have developed the common core principle for self-care. The toolkit includes focus on;Person-centred practiceEffective communicationWell-informed decisionsLearning and developmentNew technologySupport NetworksRisk​

The role of housing in effective hospital discharge The role of housing in effective hospital discharge

Working with the Chartered Institute of Housing, we've produced a set of case studies from a wide range of housing providers who have shared their experiences of developing hospital discharge services, including what this has meant for their workforce.

NICE quality standard on the prevention or delay of harmful use of drugs by children, young people and adults most likely to start using drugs, or already experimenting or using drugs occasionally. It includes statements and measures on:• assessment of care leavers• information and advice for adultsThe statements are specific and concise and focus on priorities for quality improvement. In particular, please see statement 4.

NG96 Care and support of people growing older with learning disabilities (2018) NG96 Care and support of people growing older with learning disabilities (2018)

This guideline covers care and support for adults with learning disabilities as they grow older. It covers identifying changing needs, planning for the future, and delivering services including health, social care and housing. It aims to support people to access the services they need as they get older.

Relates to:Providers of the regulated activity ‘Accommodation for persons who require nursing or personal care’. Prompts that may be used by CQC inspectors to explore this…

E6.1 How are people involved in decisions about the environment?

E6.2 How do the premises meet people’s diverse care, cultural and support needs?

E6.3 What arrangements are there to ensure people have access to appropriate space:

in gardens and other outdoor spaces

to see and look after their visitors

for meaningful activities

to spend time together

to be alone?

E6.4 How does the signage, the decoration and other adaptations to the premises help to meet people’s needs and promote their independence? How are any changes to the environment managed to avoid causing distress to people who live there?

Products that can help include...

The dementia environment in a care home (2013) The dementia environment in a care home (2013)

Use this film to find out how simple changes can create a more dementia friendly care home environment.These include:

E7.1 Do staff understand the relevant consent and decision-making requirements of legislation and guidance, including the Mental Capacity Act 2005 and the Children’s Acts 1989 and 2004 and other relevant national guidance?

E7.2 How are people supported to make their own decisions in line with relevant legislation and guidance?

E7.3 How and when is possible lack of mental capacity to make a particular decision assessed and recorded?

E7.4 How is the process for seeking consent monitored and reviewed to ensure it meets legal requirements and follows relevant national guidance?

E7.5 When people lack the mental capacity to make a decision, how do staff ensure that best interests decisions are made in accordance with legislation?

E7.6 How does the service promote supportive practice that avoids the need for physical restraint? Where physical restraint may be necessary, how does the service ensure that it is used in a safe, proportionate, and monitored way as part of a wider person-centred support plan?

E7.7 Do staff recognise when people aged 16 and over, who lack mental capacity, are being deprived of their liberty, and do they seek authorisation to do so when they consider it necessary and proportionate?

The Directory aims to raise awareness about the Mental Capacity Act, including the Deprivation of Liberty Safeguards. It contains material for people who may be subject to the Act’s provisions, and for professionals from a range of backgrounds.​​

We've created learning and development materials to help with the changes brought about by the Care Act 2014. The materials are to be used as a first step towards helping and building a competent workforce. The Care Act materials include focus on;